STD/HIV Prevention Practices Among Primary Care Clinicians: Risk Assessment, Prevention Counseling, and Testing

The authors' objective in the current study was to describe current practices of primary care (PC) clinicians for STD/HIV control services, including risk assessment, prevention counseling, and testing.

Qualitative interviews were conducted to identify clinical strategies. Via mail, a random sample of Washington State providers -- general internists, family physicians, obstetrician-gynecologists, nurse practitioners, and certified nurse midwives -- was surveyed. The authors then identified characteristics of clinicians and their practices associated with each strategy and universal provision of each service.

In all, 519 clinicians (80 percent adjusted response rate) were included. Services were provided to selected patients whom clinicians considered high-risk. Universal practices were less common: risk assessment (56 percent), prevention counseling (60 percent), STD testing (30 percent), and HIV testing (19 percent). Nurses, those more recently trained, and clinicians who saw more STD patients were more likely to offer universal services.

"Different types of PC clinicians use widely differing clinical strategies, and many use selective rather than universal approaches to STD/HIV control services," the authors concluded, noting that further research is needed to create tailored interventions to improve provision of these services.

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